Antenatal and preschool iron and zinc use and cognition

产前和学龄前铁和锌的使用和认知

• 批准号: 7090538
• 负责人: PARUL CHRISTIAN
• 金额: $ 53.54万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7090538
• 关键词: Asia; child physical development; child psychology; clinical research; cognition; developmental nutrition; diet therapy; dietary iron; dietary supplements; dietary trace element; folate; human subject; human therapy evaluation; intelligence; interview; longitudinal human study; middle childhood (6-11); mother /embryo /fetus nutrition; neuropsychology; newborn human (0-6 weeks); nutrient interaction; nutrition related tag; patient oriented research; pregnancy; preschool child (1-5); psychomotor function; zinc

DESCRIPTION (provided by applicant): Chronic deficiency of essential micronutrients is the most common, preventable form of malnutrition in the developing world, affecting millions of infants, young children and pregnant women. Interest is growing in understanding effects of specific micronutrient deficiencies early in life, particularly iron and zinc, on child development. Adequate nutriture of both iron and zinc is necessary for optimal brain development and functioning. Deficiencies of either nutrient in fetal or early postnatal life may lead to irreversible neurocognitive dysfunction and impaired motor or behavioral development. Yet, experimental data are lacking to reveal either deficiency as a cause, or the developmental benefits of iron or zinc supplementation in undernourished populations. A unique opportunity exists in rural Nepal to examine effects of iron supplementation, with or without added zinc, during (i) pregnancy (in utero), (ii) early childhood and (iii) both periods on neurocognitive function in a cohort of 1750 children at 6-7 yr of age, the usual age at school entry. Recruited children will have participated in two, previous randomized controlled supplementation trials: one in which their mothers received either placebo or iron (+folic acid), with or without zinc daily from 1st trimester to 6 weeks post partum, and the second in which the children themselves were dosed daily with placebo, iron and/or zinc, in a 2x2 factorial design, when they were 12 to 35 months of age. -Thus, by preserving each original design, the proposed study will retain inferential strength of a 2-stage randomized trial. Over 18 months, children will be evaluated at home and in a clinic by standard tests of intelligence, motor function, affect and behavior. We will assess whether children in any of our supplementation groups show faster processing of information and greater inhibitory control, cognitive functions that rely on dopaminergic pathways, which in turn are sensitive to iron deficiency. However, it is also possible that the cumulative effect of supplementation could have a more general effect on intellectual functioning, which we assess independently. Socioeconomic status, home environment, and nutrition and hearth status will also be assessed. Analyses will evaluate child outcomes by original matemo-child supplement exposures. The study will fill critical gaps in knowledge and inform policy on the efficacy of selective micronutrient interventions in pregnancy and early childhood to improve school-aged cognition.

描述（由申请人提供）：必需微量营养素的慢性缺乏是发展中国家最常见、可预防的营养不良形式，影响着数百万婴儿、幼儿和孕妇。人们越来越有兴趣了解生命早期特定微量营养素缺乏（特别是铁和锌）对儿童发育的影响。充足的铁和锌营养对于大脑的最佳发育和功能是必要的。胎儿或产后早期缺乏任何一种营养素都可能导致不可逆的神经认知功能障碍以及运动或行为发育受损。然而，缺乏实验数据来揭示营养不良人群中缺乏铁或锌的原因，或补充铁或锌的发育益处。尼泊尔农村地区有一个独特的机会，可以在 1750 名儿童的队列中检查（i）怀孕（子宫内）、（ii）幼儿期和（iii）这两个时期补充铁（添加或不添加锌）对神经认知功能的影响6-7岁，通常入学年龄。招募的儿童将参加之前的两项随机对照补充剂试验：一项试验中，他们的母亲从妊娠第一个月到产后 6 周每天接受安慰剂或铁（+叶酸），含或不含锌；第二项试验中，他们的母亲接受安慰剂或铁（+叶酸），每天服用或不服用锌。当儿童 12 至 35 个月大时，他们自己每天按照 2x2 析因设计服用安慰剂、铁和/或锌。 -因此，通过保留每个原始设计，拟议的研究将保留两阶段随机试验的推理强度。在 18 个月内，儿童将在家中和诊所接受智力、运动功能、情感和行为的标准测试评估。我们将评估我们的任何补充组中的儿童是否表现出更快的信息处理和更强的抑制控制，以及依赖多巴胺能途径的认知功能，而多巴胺能途径又对缺铁敏感。然而，补充的累积效应也可能对智力功能产生更普遍的影响，我们对此进行独立评估。社会经济状况、家庭环境以及营养和壁炉状况也将被评估。分析将通过原始的伴侣-儿童补充剂暴露来评估儿童的结果。该研究将填补知识方面的关键空白，并为怀孕和幼儿期选择性微量营养素干预措施的有效性提供政策信息，以改善学龄认知能力。